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https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#1
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: To prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with the newborns that delivered from mothers that did not have an intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28168591/neonatal-abstinence-syndrome-trend-and-expenditure-in-louisiana-medicaid-2003-2013
#2
Ekwutosi M Okoroh, Rebekah E Gee, Baogong Jiang, Melissa B McNeil, Beverly A Hardy-Decuir, Amy L Zapata
Objectives Determine trends in incidence and expenditure for perinatal drug exposure and neonatal abstinence syndrome (NAS) among Louisiana's Medicaid population. We also describe the maternal characteristics of NAS affected infants. Methods Retrospective cohort analysis using linked Medicaid and vital records data from 2003 to 2013. Conducted incidence and cost trends for drug exposed infants with and without NAS. Also performed comparison statistics among drug exposed infants with and without NAS and those not drug exposed...
February 6, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28156021/loss-of-cutaneous-microbial-diversity-during-first-three-weeks-of-life-in-very-low-birth-weight-infants
#3
A Salava, V Aho, E Lybeck, P Pereira, L Paulin, I Nupponen, A Ranki, P Auvinen, S Andersson, A Lauerma
Neonatal sepsis (NS) is a frequent problem in neonatal intensive care, especially in preterm and very low birth weight (VLBW) infants. The objective of the study was to characterize the cutaneous bacterial microbiome in VLBW infants treated in the neonatal intensive care unit (NICU). Non-invasive skin microbiome specimens were taken repeatedly from 12 VLBW infants during treatment in NICU starting on the first day of life. All infants received benzylpenicillin and netilmicin during the first 1-5 postnatal days...
February 3, 2017: Experimental Dermatology
https://www.readbyqxmd.com/read/28134705/cutaneous-manifestations-of-systemic-viral-diseases-in-neonates-an-update
#4
Stephanie A Castillo, Anh Khoa Pham, James G Dinulos
PURPOSE OF REVIEW: Dermatologic findings may be the first signs of a neonatal viral infection. This review provides an update of the diagnostic features and therapies for selected viral illnesses [herpes simplex virus (HSV), varicella zoster virus, enterovirus, and Zika virus] that present with cutaneous manifestations in the neonate. RECENT FINDINGS: HSV DNA polymerase chain reaction of plasma and cerebrospinal fluid, routinely used in the diagnosis of neonatal HSV, may have expanded utility in assessing prognosis and acyclovir therapeutic efficacy...
January 27, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28095812/maternal-sepsis-complicating-arabin-cervical-pessary-placement-for-the-prevention-of-preterm-birth-a-case-report
#5
Begoña Martinez de Tejada
BACKGROUND: Preterm delivery is a major health problem and contributes to more than 50% of all neonatal and infant deaths. Recently, there has been a renewed interest in the use of cervical pessaries as a safe and effective intervention with few maternal side-effects for the prevention of preterm birth in both single and twin pregnancies. CASE PRESENTATION: A 43-year-old gravida 5, para 1 (previous preterm birth at 24 weeks) patient with an in vitro fertilization twin pregnancy had an Arabin cervical pessary placed at 19 weeks of pregnancy due to the presence of cervical funneling identified by ultrasound screening...
January 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#6
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27911391/a-murine-model-of-group-b-streptococcus-vaginal-colonization
#7
Kathryn A Patras, Kelly S Doran
Streptococcus agalactiae (group B Streptococcus, GBS), is a Gram-positive, asymptomatic colonizer of the human gastrointestinal tract and vaginal tract of 10 - 30% of adults. In immune-compromised individuals, including neonates, pregnant women, and the elderly, GBS may switch to an invasive pathogen causing sepsis, arthritis, pneumonia, and meningitis. Because GBS is a leading bacterial pathogen of neonates, current prophylaxis is comprised of late gestation screening for GBS vaginal colonization and subsequent peripartum antibiotic treatment of GBS-positive mothers...
November 16, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27899925/increased-risk-of-group-b-streptococcus-invasive-infection-in-hiv-exposed-but-uninfected-infants-a-review-of-the-evidence-and-possible-mechanisms
#8
REVIEW
Nicolas Dauby, Mustapha Chamekh, Pierrette Melin, Amy L Slogrove, Tessa Goetghebuer
Group B Streptococcus (GBS) is a major cause of neonatal sepsis and mortality worldwide. Studies from both developed and developing countries have shown that HIV-exposed but uninfected (HEU) infants are at increased risk of infectious morbidity, as compared to HIV-unexposed uninfected infants (HUU). A higher susceptibility to GBS infections has been reported in HEU infants, particularly late-onset diseases and more severe manifestations of GBS diseases. We review here the possible explanations for increased susceptibility to GBS infection...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27875686/early-onset-neonatal-sepsis-and-the-implementation-of-group-b-streptococcus-prophylaxis-in-a-brazilian-maternity-hospital-a-descriptive-study
#9
Felipe Teixeira de Mello Freitas, Gustavo Adolfo Sierra Romero
OBJECTIVES: To describe early-onset neonatal sepsis (EOS) epidemiology in a public maternity hospital in Brasilia, Brazil. METHODS: We defined EOS as a positive blood culture result obtained from infants aged ≤72 hours of life plus treatment with antibiotic therapy for ≥5 days. Incidence was calculated based on the number of cases and total live births (LB). This is a descriptive study comparing the period of 2012-2013 with the period of 2014-September 2015, before and after implementation of antibiotic prophylaxis during labor for group B streptococcus (GBS) prevention, respectively...
January 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27787388/hydrocephalus-secondary-to-chemotherapy-in-a-case-of-prenatally-diagnosed-giant-immature-grade-3-sacrococcygeal-teratoma-a-case-report-and-literature-review
#10
REVIEW
Ioan Sarbu, Demetra Socolov, Razvan Socolov, Ingrith Miron, Mioara Trandafirescu, Smaranda Diaconescu, Carmen Iulia Ciongradi
INTRODUCTION: Sacrococcygeal teratoma (SCT) is a rare tumor in the general population, arising from multipotent stem cells. Whereas most of the cases diagnosed postnatally have good prognosis, the rate of mortality and morbidities associated with prenatally diagnosed SCT remain high, with a reported mortality rate of 30% to 50%. The outcome of fetal SCT can be unpredictable, with some cases with slow growth during fetal life, whereas others grow rapidly, causing multiple complications; also, some of these tumor will develop triggering fetal (preterm delivery, high-output cardiac failure, hydrops fetalis, intrauterine death) or maternal complications (distocia, placentomegaly, maternal mirror syndrome-preeclampsia)...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27776846/-prevention-of-preterm-birth-complications-by-antenatal-corticosteroid-administration
#11
T Schmitz
OBJECTIVE: To evaluate short- and long-term benefits and risks associated with antenatal administration of a single course of corticosteroids and the related strategies: multiple and rescue courses. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Antenatal administration of a single course of corticosteroids before 34 weeks of gestation is associated in the neonatal period with a significant reduction of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and death (LE1), and in possibly childhood with a reduction of cerebral palsy and increased psychomotor development index and intact survival (LE3)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27717356/estimating-the-costs-for-the-treatment-of-abortion-complications-in-two-public-referral-hospitals-a-cross-sectional-study-in-ouagadougou-burkina-faso
#12
Patrick G C Ilboudo, Giulia Greco, Johanne Sundby, Gaute Torsvik
BACKGROUND: Treatment costs of induced abortion complications can consume a substantial amount of hospital resources. This use of hospitals scarce resources to treat induced abortion complications may affect hospitals' capacities to deliver other health care services. In spite of the importance of studying the burden of the treatment of induced abortion complications, few studies have been conducted to document the costs of treating abortion complications in Burkina Faso. Our objective was to estimate the costs of six abortion complications including incomplete abortion, hemorrhage, shock, infection/sepsis, cervix or vagina laceration, and uterus perforation treated in two public referral hospital facilities in Ouagadougou and the cost saving of providing safe abortion care services...
October 7, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27586209/critically-ill-obstetric-patients-requiring-mechanical-ventilation-in-rural-western-india-a-retrospective-analysis
#13
Smruti B Vaishnav, Bhalendu Vaishnav, Kailas N Desai, Nitin S Raithatha, Neeta S Bose
BACKGROUND: There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill obstetric patients from rural areas, especially those requiring tertiary care support and ventilator therapy. METHODS: We retrospectively analysed the aetiological, clinical, interventional and outcome-related factors of obstetric patients requiring mechanical ventilation in western India. We analysed factors that influence seeking of antenatal care, pregnancy and its complications, severity assessment score, indications and initiation of mechanical ventilation, multiorgan failure and their correlation with maternal mortality...
March 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/27547966/an-elevation-of-serum-ferritin-level-might-increase-clinical-risk-for-the-persistence-of-patent-ductus-arteriosus-sepsis-and-bronchopulmonary-dysplasia-in-erythropoietin-treated-very-low-birth-weight-infants
#14
Masayuki Ochiai, Hiroaki Kurata, Hirosuke Inoue, Koichi Tanaka, Yuki Matsushita, Junko Fujiyoshi, Yoshifumi Wakata, Kiyoko Kato, Tomoaki Taguchi, Hidetoshi Takada
BACKGROUND: The substantial risk of iron overload is not routinely monitored in most of the neonatal intensive care units (NICUs) in Japan; however, blood transfusion is an essential strategy for successfully treating preterm low-birth-weight infants. OBJECTIVE: The aim of this study was to investigate the iron status and clinical features of infants with a birth weight of <1,500 g, i.e. very-low-birth-weight infants (VLBWIs). METHODS: This prospective observational study enrolled 176 (82...
2017: Neonatology
https://www.readbyqxmd.com/read/27533103/evaluation-and-management-of-newborns-with-suspected-early-onset-sepsis-comparison-of-two-approaches-and-suggestion-for-guidelines
#15
Arieh Riskin, Yael Aloni, Amir Kugelman, Arina Toropine, Waseem Said, David Bader
Objective Although its incidence is declining with the widespread use of intrapartum antibiotics, early-onset sepsis (EOS) continues to be associated with high morbidity and mortality. Maternal, infant, and peripartum risk factors, as well as infant's laboratory tests, have been used to try and identify asymptomatic newborns at risk. In this study, we reevaluate the management of newborns at risk for EOS by comparing our outcomes using two different approaches. Study Design Comparison of clinical data and outcomes of newborns at risk for EOS between two study periods, in which we have used two different protocols for their evaluation and management...
August 17, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27512494/two-case-reports-of-generalized-pustular-psoriasis-of-pregnancy-different-outcomes
#16
REVIEW
Aoibheann Flynn, Naomi Burke, Bridgette Byrne, Noreen Gleeson, Bairbre Wynne, Louise Barnes
Generalized pustular psoriasis of pregnancy is a rare dermatosis with potential serious consequences for both the mother and fetus. Treatment is difficult and historically steroids were the mainstay of treatment. Cyclosporin has been used for a few cases resistant to steroids. We report our own experience of two cases of generalized pustular psoriasis of pregnancy. Cases of generalized pustular psoriasis of pregnancy need review by a dermatologist with experience of skin disorders in pregnancy. Both the fetus and mother need to be monitored closely when systemic illness occurs, as there is a risk of stillbirth...
June 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27435163/metformin-in-women-with-type-2-diabetes-in-pregnancy-mity-a-multi-center-randomized-controlled-trial
#17
Denice S Feig, Kellie Murphy, Elizabeth Asztalos, George Tomlinson, Johanna Sanchez, Bernard Zinman, Arne Ohlsson, Edmond A Ryan, I George Fantus, Anthony B Armson, Lorraine L Lipscombe, Jon F R Barrett
BACKGROUND: The incidence of type 2 diabetes in pregnancy is rising and rates of serious adverse maternal and fetal outcomes remain high. Metformin is a biguanide that is used as first-line treatment for non-pregnant patients with type 2 diabetes. We hypothesize that metformin use in pregnancy, as an adjunct to insulin, will decrease adverse outcomes by reducing maternal hyperglycemia, maternal insulin doses, maternal weight gain and gestational hypertension/pre-eclampsia. In addition, since metformin crosses the placenta, metformin treatment of the fetus may have a direct beneficial effect on neonatal outcomes...
July 19, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27375613/hiv-exposed-uninfected-infants-in-zimbabwe-insights-into-health-outcomes-in-the-pre-antiretroviral-therapy-era
#18
Ceri Evans, Jean H Humphrey, Robert Ntozini, Andrew J Prendergast
The ZVITAMBO trial recruited 14,110 mother-infant pairs to a randomized controlled trial of vitamin A between 1997 and 2000, before the availability of antiretroviral therapy for HIV prophylaxis or treatment in Zimbabwe. The HIV status of mothers and infants was well characterized through 1-2 years of follow-up, leading to the largest cohort to date of HIV-exposed uninfected (HEU) infants (n = 3135), with a suitable comparison group of HIV-unexposed infants (n = 9510). Here, we draw on 10 years of published findings from the ZVITAMBO trial...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27357953/community-s-perceptions-of-pre-eclampsia-and-eclampsia-in-sindh-pakistan-a-qualitative-study
#19
Asif Raza Khowaja, Rahat Najam Qureshi, Sana Sheikh, Shujaat Zaidi, Rehana Salam, Diane Sawchuck, Marianne Vidler, Peter von Dadelszen, Zulfiqar Bhutta
BACKGROUND: Maternal mortality is of global public health concern and >99 % of maternal deaths occur in less developed countries. The common causes of direct maternal death are hemorrhage, sepsis and pre-eclampsia/eclampsia. In Pakistan, pre-eclampsia/eclampsia deaths represents one-third of maternal deaths reported at the tertiary care hospital settings. This study explored community perceptions, and traditional management practices about pre-eclampsia/eclampsia. METHODS: A qualitative study was conducted in Sindh Province of Pakistan from February to July 2012...
June 8, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27356646/-analysis-of-clinical-characteristics-of-necrotizing-enterocolitis-in-term-infants
#20
T Qian, R Zhang, L Zhu, P Shi, J Yang, Y Liu, J L Yu, X G Zhou, Y Yang, Y P Qiu, L Liu, Q F Wei, F L Xu, Y F Li, C Chen
OBJECTIVE: To investigate the characteristics and outcomes of necrotizing enterocolitis (NEC) in Chinese term infants population. METHODS: A national neonatal necrotizing enterocolitis network was established. Neonates as having necrotizing enterocolitis with gestation age ≥37 weeks were identified if they met the accepted diagnostic criterion during the study period from Jan 1(st) 2011 to Dec 31(st) 2011. The data of maternal and neonates' characteristics, the comorbidities, the clinical interventions prior to NEC, the clinical courses and radiology results, the medical and surgical treatment and the outcomes were collected...
June 14, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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